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Clinical
Case report
Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report
  1. Alje P van Dam1,2,
  2. Marc L van Ogtrop2,
  3. Daniel Golparian3,
  4. Jan Mehrtens4,
  5. Henry J C de Vries5,6,7,
  6. Magnus Unemo3
  1. 1Public Health Laboratory, Cluster of Infectious Diseases, Amsterdam Health Service, Amsterdam, The Netherlands
  2. 2Department of Microbiology, Onze Lieve Vrouwe Gasthuis General Hospital, Amsterdam, The Netherlands
  3. 3Department of Laboratory Medicine, Clinical Microbiology, WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden
  4. 4Integral Physician Practice West, Amsterdam, The Netherlands
  5. 5STI Outpatient Department, Cluster of Infectious Diseases, Amsterdam Health Service, Amsterdam, The Netherlands
  6. 6Centre for Infections and immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  7. 7Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Alje P van Dam, Public Health Laboratory, Cluster of Infectious Diseases, Amsterdam Health Service, Nieuwe Achtergracht 100, Amsterdam 1018WT, The Netherlands; avdam{at}ggd.amsterdam.nl

Abstract

We describe the first case of treatment failure of gonorrhoea with a third generation cephalosporin, cefotaxime 1g intramuscularly, in the Netherlands. The case was from a high-frequency transmitting population (men having sex with men) and was caused by the internationally spreading multidrug-resistant gonococcal NG-MAST ST1407 clone. The patient was clinically cured after treatment with ceftriaxone 500 mg intramuscularly and this is the only third generation cephalosporin that should be used for first-line empiric treatment of gonorrhoea. Increased awareness of failures with third generation cephalosporins, enhanced monitoring and appropriate verification of treatment failures including more frequent test-of-cures, and strict adherence to regularly updated treatment guidelines are essential globally.

  • ANTIBIOTIC RESISTANCE
  • GONORRHOEA
  • NEISSERIA GONORRHOEA
  • URETHRITIS
  • GAY MEN

https://doi.org/10.1136/sextrans-2014-051552

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